2024 BIPOC Membership Scholarship Program

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* 1. Contact Information

Name *

Institution *

City/Town

State/Province

Country

Email Address *

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* 2. Degree

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* 3. Position / Title

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* 4. Year in Program (if student)

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* 5. Advisor Name and Email

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* 6. Primary Focus

Clinical

Research

Both

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* 7. Populations of Interest

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* 8. Personal Bio (no more than two to three paragraphs in length)

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* 9. Your CV

PDF, DOC, DOCX file types only.

Choose File

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* 10. Personal Statement

Submit a short statement (no more than one page in length) explaining their area of professional or academic focus; why the would like to become an ADAA member; how ADAA may benefit their careers; and how they anticipate contributing to ADAA's mission.

PDF, DOC, DOCX file types only.

Choose File

Applications should be submitted by 11:59 pm ET, Tuesday, December 12, 2023. Recipients will be notified January 2023.